A combination crown lengthening and implant placement guide.

Surgical procedures, including crown lengthening and implant placement, have become more predictable and less invasive because of the use of digital planning tools. A method combining a cone beam computed tomography and a digital scan with a virtual planning software program is described to fabricate a combination guide for both surgical esthetic crown lengthening and guided implant placement.

A comparison of digital and conventional fabrication techniques for an esthetic maxillofacial prosthesis for the cheek and lip.

Maxillofacial prostheses have traditionally been manufactured by pouring silicone into molds. However, the development of computer-aided design and computer-aided manufacturing (CAD-CAM) systems allows the virtual planning, design, and manufacture of maxillofacial prostheses through the direct 3-dimensional printing of silicone. This clinical report describes the digital workflow as an alternative to the conventional method of restoring a large midfacial defect in the right cheek and lip. In addition, the approaches were nonblinded evaluated in relation to outcomes and time efficiency, while marginal adaptation and esthetics, including patient satisfaction, were assessed for both prostheses fabricated. The digital prosthesis had acceptable esthetics and fit with improved patient satisfaction, especially in terms of efficiency, comfort, and speed of the digital workflow.

Protocol for the clinical assessment of passive fit for multiple implant-supported prostheses: A dental technique.

With monolithic materials and the new technologies for framework production, assessment of passive fit before fabrication of the definitive prosthesis or its framework is essential to avoid prosthesis remakes. This article describes an updated clinical protocol to assess passive fit during the prosthesis fabrication process through the systematic use of tactile feel while tightening the retaining screws, the visual or radiographic evaluation when performing the 1-screw or Sheffield fit test, and the torque/time graph obtained during the placement of the implant- or abutment-retaining screws with a torque-controlled surgical motor.

A method for determining the position of the abutment screw of any cement-retained implant-supported prosthesis.

Removing cement-retained implant-supported prostheses may be challenging for clinicians. A method combining a cone beam computed tomography (CBCT) and a digital scan with a virtual surgical planning software program is described to identify the perforation site of a cement-retained implant-supported prosthesis to locate the abutment screw.

Digital implant impressions by cone-beam computerized tomography: a pilot study.

OBJECTIVES: To evaluate the adjustment of structures designed from a digital impression of implants obtained by cone-beam computerized tomography (CBCT). MATERIALS AND METHODS: Thirty implants were placed in five edentulous mandibles of fresh cadaver heads, six per mandible. Special scan bodies were screwed in the implants and a CBCT was taken. DICOM images were converted to STL and digitally processed to obtain a digital model of the implants. A Cr-Co structure was designed and milled for each mandible, and the adjustment was assessed as in a real clinical situation: passivity while screwing, radiographic fitting, optical fitting, and probing. RESULTS: Good adjustment was found in three of the structures, and only slight discrepancies were found in the other two. CONCLUSION: Cone-beam computerized tomography might be a valid impression-taking method in full-mouth rehabilitations with implants. Further evaluations are needed with more implant and CBCT systems. The radiation dose might be considered when deciding to use this impression system. The types of patients appropriate for this treatment option should also be determined to fulfill the principles of the ALARA law.

The Use of Statins as an Adjunctive Periodontal Disease Treatment: Systematic Review and Meta-Analysis.

BACKGROUND: the purpose of this systematic review was to assess the clinical and radiographic effect of subgingival-administered statins as an adjunct periodontal treatment in patients with periodontitis. METHODS: Electronic literature searches in Medline/PubMed and the Cochrane Library were conducted to identify all relevant articles. Eligibility was based on inclusion criteria which included Randomized Controlled Trials (RCTs) published after 2010, where the periodontal variables were assessed before and after periodontal treatment in combination with a statin administration. The risk of bias was assessed with the ROBINS-2 tool. The outcome variables were probing depth, clinical attachment level, bleeding on probing, and bone fill in systematically healthy patients, patients with type 2 diabetes, and smokers. RESULTS: Out of 119 potentially eligible articles, 18 randomized controlled trials were included with a total of 1171 participants. The data retrieved from the meta-analysis showed the positive effect that statins have as an adjunctive periodontal disease treatment. When comparing the different types of statins, the PD reduction in the Simvastatin group was significantly higher than the Atorvastatin group at 6 months and at 9 months, while no differences between statins were found for the rest of the outcomes. Over 66% of the articles presented an overall risk of bias with some concerns, making this a limitation of this present RCT. CONCLUSIONS: The adjunct administration of statins has proven to have a positive effect on the periodontium by improving both clinical and radiographic parameters by a considerable margin.

A straightforward protocol for designing an interim hollow shell with open-source software.

BACKGROUND: An interim hollow shell (IHS) is a temporary prosthesis that adapts like a cap over a prepared tooth abutment. Using a conventional protocol to fabricate IHS from casts of the initial situation or the wax-up can be challenging, time-consuming, and sometimes frustrating. A digital workflow makes this process quicker and more convenient. The IHS must be first designed with computer-aided design (CAD), then fabricated with computer-aided manufacture (CAM). Proprietary dental software is commonly used for the design process but needs to be purchased. OBJECTIVE: To describe a step-by-step technique for designing an IHS for posterior relining with open-source software. METHODS: This paper describes a straightforward procedure to design an IHS from a dental scan of the initial situation or a digital wax-up for an esthetic and functional temporary rehabilitation. RESULTS: An IHS can be quickly designed using open-source software by copying an existing restoration or a conventional or digital wax-up. Then, the design can be 3D printed using a biocompatible resin. CONCLUSIONS: The clinician can use open-source software to design IHSs, which are then 3D printed using a biocompatible resin. CLINICAL RELEVANCE: The clinician can design IHSs from a dental scan of the initial situation or a wax-up using open-source software by following the step-by-step protocol outlined in this paper. The restoration can then be 3D printed using a biocompatible resin.

Comparison of the Marginal Fit of Cobalt-Chromium Metal-Ceramic Crowns Fabricated by CAD/CAM Techniques and Conventional Methods at Three Production Stages.

PURPOSE: The aim of this study was to compare the marginal fit of cobalt-chromium crowns fabricated using conventional casts and computer-aided design/computer-assisted manufacturing (CAD/CAM) techniques at three stages of production: metal coping, after porcelain firing, and after cementation. MATERIALS AND METHODS: A total of 80 metal-ceramic crowns were fabricated using four different techniques: lost wax casting, milling, laser sintering, and milling of a presintered metal block. Marginal fit was measured at each manufacturing stage. RESULTS: The porcelain firing stage improved marginal fit. CAD/CAM techniques resulted in better marginal fit than did conventional casting techniques at all manufacturing stages. CONCLUSION: CAD/CAM techniques improve marginal fit.